Although obesity among young people in the United States is a major problem, teen bariatric surgery is very uncommon. Minors represent only about one-half of 1 percent of all weight-loss surgery (WLS) patients. Fewer than 1,000 pediatric patients per year have a WLS procedure. However, a number of hospitals are currently gathering data in a Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study funded by the National Institutes of Health (NIH). This research study will follow post-WLS teens long term and learn more about risks and benefits for pediatric patients. As of 2013, this study is still ongoing.

What Types of Bariatric Surgery Are Offered to Teens?

Three of the four major types of WLS performed on adults are also approved for pediatric patients in the United States. These are:

Gastric Bypass (Roux-En-Y)

This is the most common form of WLS for both adults and teens. It involves making the stomach much smaller and attaching it to a lower section of the intestine, bypassing a short segment of intestine and most of the stomach. This limits the amount of food that can be eaten at one time and prevents the body from absorbing as much of the nutrients in each meal. The removed part of the stomach and intestine are left inside the body so they stay “alive” just in case the procedure must be reversed.

Gastric Banding (Lap-Band)

A medical device in the shape of a fluid-filled silicone band is fitted around the stomach leaving only a small pouch just below the esophagus to hold food during a meal. The opening down into the rest of the stomach is squeezed down very small so food takes a while to pass through. A tube goes from the band to a port just under the skin so the amount of fluid in the band can be adjusted as needed. A gastric band is the only readily reversible form of teen WLS, but it is intended to be a permanent way to support healthy eating.

Vertical Gastric Sleeve (Vertical Sleeve Gastrectomy or VSG)

In this surgery, about 75 to 80 percent of the stomach is completely removed. The remaining portion of the stomach is the shape of a tube or sleeve. Food fills up this new, small stomach very fast and makes patients feel full longer after each meal. This procedure is not reversible. However, since it has less of a risk for malnutrition than gastric bypass, some bariatric surgeons prefer this approach for teens.

Who Is a Candidate for Teen WLS?

Patients must be finished with puberty to be candidates for any weight-loss surgery. Ideally, they have also achieved most of their adult height (these patients are usually 14 or older). Teens who are candidates for WLS are those who have been very obese for at least a few years. Many have struggled with obesity since early childhood. They are usually at least 100 pounds overweight with a BMI of 40 or a BMI of at least 35 with one or more serious medical conditions that cou